JPH08252263A - 電子外科切開器具とそれを用いた電子外科切開装置 - Google Patents

電子外科切開器具とそれを用いた電子外科切開装置

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Publication number
JPH08252263A
JPH08252263A JP7333695A JP33369595A JPH08252263A JP H08252263 A JPH08252263 A JP H08252263A JP 7333695 A JP7333695 A JP 7333695A JP 33369595 A JP33369595 A JP 33369595A JP H08252263 A JPH08252263 A JP H08252263A
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blade
electrosurgical
incision
conductive layer
instrument according
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Nigel M Goble
マーク ゴーブル ナイジェル
Colin C O Goble
チャールズ オーウェン ゴーブル コリン
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Gyrus Medical Ltd
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/1432—Needle curved

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Abstract

(57)【要約】 【課題】 組織の接触インピーダンスを低下させ、分離
前に組織を効率よく乾燥する。また、機械的分離に先立
って、広範囲の組織を乾燥する。 【解決手段】 電子外科切開器具は、鋏動作を行う複合
刃体１２と単純刃体１４とが本体に軸を介して取り付け
られている。本体に組み込まれた配線導体が複合刃体１
２と単純刃体１４とに電子外科電圧を供給する。複合刃
体１２は、外側電極層１２Ａ、内側導電層１２Ｃ、およ
びその間に挟まれた絶縁層１２Ｂを有する。上記配線導
体は、外側電極層１２Ａおよび内側導電層１２Ｃに接続
される。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】本発明は、鋏の作用を行う一
対の刃体を有する電子外科切開器具とそれを用いた電子
外科切開装置に関し、詳しくは、電子外科電圧が印加さ
れた時、生体組織を乾燥させると同時に切開する電子外
科切開器具とそれを用いた電子外科切開装置に関するも
のである。
【０００２】
【従来の技術】次のような鋏器具を用いて外科切開を行
うことが知られている。すなわち、長手のシャフトの一
端に一対の刃体が取り付けられている。刃体と、シャフ
トの他端に設けられた操作部との間には制御棒が伸びて
いる。各刃体は、この制御棒の動きに応じて、シャフト
を横切る軸の回りに回転できるようになっている。２本
の刃体は互いに電気的に絶縁されており、電気的に短絡
することなしに電子外科の二極電源に接続できるよう
に、刃体の相対する面はセラミックコーティングされて
いる。刃体に挟まれた組織には、刃体の切開部が交わる
位置から離れたところで電子外科電流が流される。それ
によって、刃体を互いに閉じて組織を機械的に分離する
前に、組織を乾燥させている。
【０００３】
【発明が解決しようとする課題】しかしながら、上記従
来の電子外科切開器具では、上述のように、両刃体が電
気的に短絡することがないように刃体の相対する面がセ
ラミックコーティングされているため、組織と、刃体に
おける組織に電圧を印加する部分との接触が少ない。し
たがって、組織の接触インピーダンスが高い。そのた
め、分離前に組織を効率よく乾燥することができないと
いう問題点がある。
【０００４】また、刃から組織に電圧を印加することが
できるのは鋏をある程度閉じてからであり、組織を挟む
ために鋏を開放状態にしているあいだは刃から組織に電
圧を印加することができない。したがって、大容量の組
織に電流を通すことはできないので、機械的分離に先立
って、広範囲の組織を乾燥することができないという問
題点がある。
【０００５】
【課題を解決するための手段】本発明に係る電子外科切
開器具は、第一刃体および第二刃体のうちの少なくとも
一方が他方とともに鋏動作を行うために本体に旋回軸を
介して取り付けられており、第一および第二刃体に電子
外科電圧を印加するための一対の配線導体が本体に設け
られている電子外科切開器具において、上記第一刃体
は、外側電極層、内側導電層、および外側電極層と内側
導電層との間に挟持された絶縁層を含む複合刃体であ
り、上記配線導体は、外側電極層および内側導電層にそ
れぞれ接続されていることを特徴としている。
【０００６】上記の構成により、第二刃体と、第一刃体
の内側導電層とが同電位になる。そのため、両刃体が電
気的に短絡することがないように刃体の相対する面を絶
縁する必要がないので、外側電極層および第二刃体のそ
れぞれにおける組織との接触部分において導電性を有す
ることができる。その結果、鋏を閉じる動作を行ったと
きに、組織と、両刃体のうちで導電性を有して組織に電
圧を印加する部分との接触が増すので、組織の接触イン
ピーダンスが低下する。それにより、分離前に組織を効
率よく乾燥することができる。
【０００７】また、上記のように、刃体の相対する面を
絶縁する必要がないので、鋏を開放させて組織を挟み、
第二刃体が組織と接触したときに、第一刃体とともに電
流の通路が形成される。このため、比較的大容量の組織
に電流を通すことができるので、機械的分離に先立っ
て、広範囲の組織を乾燥することができる。
【０００８】好ましくは、上記配線導体のうちのひとつ
は内側導電層に直接接続されている。
【０００９】また、好ましくは、配線導体の一本は、第
二刃体に結合されるとともに、第二刃体と上記内側導電
層との間の電気的接触によって上記内側導電層に電気的
に接続されている。また、好ましくは、第二刃体は上記
内側導電層と電気的に接触した導電部を有し、上記配線
導体と上記導電部とは、配線導体と内側導電層との間に
上記導電部が電気的に直列に位置するように接続されて
いる。
【００１０】上記各刃体は漸進して剪断するように方向
付けられた切開部を有し、上記各切開部は金属材料で構
成されている。実際には、上記第二刃体は全体が金属体
であり、この金属体に上記切開部を設ければよい。好ま
しくは、上記刃体の両方が上記本体に上記旋回軸を介し
て取り付けられる。
【００１１】もし、上記刃体が、切開動作中に互いに面
と面で相互にかみ合うように漸進的に重なり合う剪断表
面を有し、これら両剪断表面が各刃体の導電部にあるな
らば、第一刃体の内側導電層と、第二刃体のうちで少な
くとも剪断表面を支える部分とは、同一の電位にある。
また、第一刃体の外側電極層はこれらと異なる電位にあ
る。それによって、第一刃体の外側電極層と内側導電層
との間に電界を生じるとともに、剪断表面間の電気的接
触により、第一刃体の外側電極層と第二刃体との間に電
界を生じる。
【００１２】好ましくは、上記各刃体は長手部材を備
え、上記長手部材は、外側表面、剪断表面、および切開
部を有し、上記切開部は上記刃体に沿って形成されてお
り、上記剪断表面の一方の側に沿って上記剪断表面と外
側表面との間の境界を定めている。そして、上記両刃体
は、上記剪断表面が互いに向かい合った関係を保ちつつ
閉鎖状態へ移行する際に、上記各切開部が剪断動作を進
めていくように本体に取り付けられている。そして、上
記第一刃体について、上記外側表面は、その切開部に隣
接した、刃体に沿う切開面を定めており、上記内側導電
層、絶縁層、および外側電極層のそれぞれは、上記切開
面に沿って露出されており、上記剪断表面は、上記内側
導電層上の、少なくとも、上記切開部に隣接した部分に
形成されている。
【００１３】好ましくは、上記第二刃体は、導電部と、
切開部に隣接して刃体に沿った切開面を有し、上記導電
部は、切開面に沿って、少なくとも切開部において露出
されている。好ましくは、両刃体の切開面は、少なくと
も部分的には、剪断表面に対して一般に垂直である。そ
のため、切開部の交わる位置から離れたところで、オフ
セット関係ではあるが、切開面が互いに向き合うととも
に、刃体間に横断して置かれた一片の組織と電気的接触
を作る。したがって、本電子外科切開器具を用いると、
刃体間で切開部の交わる位置から離れたところに置かれ
た組織には、その組織を通して電子外科電流が流れる。
その電流は、一方では、第一刃体の外側電極層と内側導
電層との間で、他方では、第一刃体の外側電極層と第二
刃体との間で、それぞれ流れる。これにより、刃体を閉
じる動作をする際に、切開部の交わる位置での機械的分
離に先立って、乾燥が行われる。
【００１４】ある場合、特に組織片の方向が機械的分離
に不向きな場合には、本発明の電子外科切開器具は、機
械的分離は行わずに、純粋な電子外科切開用途に用いる
ことができる。これを実施するために、好ましくは、第
一刃体の外側電極層、絶縁層、および内側導電層はそれ
ぞれ、電子外科切開部に沿って露出される。電子外科切
開部は、第一刃体の外側表面の一部を形成している。そ
して、電子外科切開部は、第一刃体の剪断表面について
上記切開部とは反対の側に隣接し、第一刃体に沿って伸
延している。
【００１５】一般に、第二刃体は第一刃体よりも狭く作
られる。そして、刃体が閉じている時には、第二刃体の
切開部は、第一刃体の剪断表面に沿うとともに、第一刃
体の電子外科切開部より引っ込んだ位置にある。したが
って、第一刃体の、切開部とは反対側に、外側電極層、
絶縁層および内側導電層が露出面を形成し、その露出面
に沿って全３層が互いに付き合って露出している。これ
により、刃体が閉じたときに電子外科電圧を絶縁層に印
加すると、第一刃体のこの露出面をナイフのように用い
ることができる。
【００１６】本発明に係る電子外科切開装置は、電子外
科用発電機および上記の電子外科切開器具を備え、上記
電子外科用発電機は、充電端子と接地端子とを有する不
平衡出力を有し、組織の乾燥と機械的切開に対しては、
上記充電端子が第一刃体の外側電極層に接続されるよう
に、上記配線導体が配設されている。同様に、電子外科
切開に対して、充電端子は、好ましくは第二刃体か、あ
るいは第一刃の内側導電層に接続される。
【００１７】また、電子外科切開器具が組織の乾燥と機
械的切開の組み合わせに用いられるか電子外科切開に用
いられるかに従って電気配線が反転するように、電子外
科切開器具に制御スイッチを組み込むことも可能であ
る。
【００１８】
【発明の実施の形態】
〔実施の形態１〕本発明の実施の一形態について図１な
いし図３に基づいて説明すれば、以下の通りである。図
１および図２に示すように、本実施の形態に係る電子外
科切開器具は、腹壁鏡用のものであり、ブロック図で示
す操作部１１、および、操作部１１に近いところに取り
付けられた長手で管状の本体１０を通常通りに有してい
る。本体１０の中心を横切るように、旋回軸である軸１
６が配置されている。本体１０の末端には、２本の切開
刃体である複合刃体（第一刃体）１２と単純刃体（第二
刃体）１４とがあり、それぞれ、軸１６の周囲を回転す
るように支軸されている。複合刃体１２と単純刃体１４
とはそれぞれ、軸１６を越えて近くまで伸びている操作
棒１８を有し、操作棒１８は、本体１０の内側で往復す
る駆動部２２の反対側の溝２０に位置するピン１８Ａを
有している。ただし、溝２０は図１では一つだけ示して
いる。制御棒２２Ａが、駆動部２２を操作部１１中のト
リガ機構（図示せず）に接続している。そのため、トリ
ガ機構が動作した時には、駆動部２２は本体１０中を縦
に移動し、上記複合刃体１２と単純刃体１４とを軸１６
の周囲に回転させるようになっている。配線導体２４・
２４は、操作部１１と複合刃体１２・単純刃体１４との
各接続部の間で、管状の本体１０の内部を通過してい
る。
【００１９】上記操作部１１は、電子外科電源としての
発電機２６に接続されている。
【００２０】図２に示すように、複合刃体１２は、金属
製の外側電極層１２Ａ、絶縁層１２Ｂおよび内側導電層
１２Ｃを含む複合刃体である。また、単純刃体１４は、
本実施の形態では、金属本体（導電部）を有する単純刃
体であって、剪断表面の幅が複合刃体１２よりも狭い。
複合刃体１２の内側導電層１２Ｃは刃体の剪断表面を形
成しており、その剪断表面の一端は切開部（機械切開
部）１２Ｄで終了している。複合刃体１２の外側表面１
２Ｅは、切開部１２Ｄから、内側導電層１２Ｃで形成さ
れる剪断表面の他端にまで回って伸延している。切開部
１２Ｄに沿っている、外側表面１２Ｅのうちの部分Ｆは
切開面である。外側電極層１２Ａは、少なくともこの切
開面１２Ｆの所では露出されている。絶縁層１２Ｂと内
側導電層１２Ｃもまた、切開面１２Ｆに沿って露出され
ている。
【００２１】単純刃体１４もまた、図１、２に示すよう
に両刃体１２、１４が閉鎖状態にあるときに複合刃体１
２の剪断表面に面する剪断表面を有している。また、単
純刃体１４は、刃体が開放状態にあるときに、オフセッ
ト関係ではあるが、複合刃体１２の切開面１２Ｆに面す
る切開面１４Ｆをも有している。単純刃体１４の切開面
１４Ｆは、刃体が閉じているときに複合刃体１２の内側
導電層１２Ｃによって形成される剪断表面を覆っている
切開部（機械切開部）１４Ｄまで存在している。
【００２２】配線導体２４・２４はそれぞれ、複合刃体
１２の外側表面１２Ｅと、単純刃体１４とに接続されて
いる。そのため、発電機２６が配線導体２４・２４の操
作部端に電圧を印加すると、一方では外側電極層１２Ａ
と内側導電層１２Ｃとの間で、他方では外側電極層１２
Ａと単純刃体１４との間で、それぞれ電子外科電圧が発
生する。
【００２３】本方法の接続の効果を図３に示す。同図
（ａ）および（ｂ）は、複合刃体１２と単純刃体１４と
の構成および、使用中における刃体間に挟んだ生体組織
片中での電子外科電流分布を示すものである。また、同
図（ｃ）は、関連する発電機２６および切替スイッチ３
４とともに示す両刃体の構成を示すものである。同図に
示すように、複合刃体１２と単純刃体１４とは、その切
開部１２Ｄ・１４Ｄの交わる位置から離れたところで刃
体間を横切る形で捉えられた組織２８の一片によって開
放されている。ここで、組織２８を通る二つの電流通路
３０と３２が存在する。電流通路３０は、図３（ａ）に
示すように、複合刃体１２の外側電極層１２Ａと内側導
電層１２Ｃとの間である。剪断表面間の電気的接触、ま
たはそれと同時の、二つの刃体の切開部１２Ｄと切開部
１４Ｄとが交わる位置から近いところでの切開部１２Ｄ
・１４Ｄ間の電気的接触により、内側導電層１２Ｃは単
純刃体１４と同じ電位にある。また、電流通路３２は、
図３（ｂ）に示すように、複合刃体１２の外側電極層１
２Ａと単純刃体１４の切開部１４Ｄとの間に伸延してい
る。実際は、二つの電流通路３０と電流通路３２とは結
合されており、複合刃体１２と単純刃体１４とが開放状
態から閉鎖状態に動く時に生ずる機械的分離に対応す
る、組織２８内のある線に沿って、乾燥動作を生み出
す。それによって、切開ラインからの出血を防止する。
【００２４】複合刃体１２の内側導電層１２Ｃと、単純
刃体１４との間には電子外科電流は流れないので、剪断
表面では絶縁物は必要ない。
【００２５】電流通路３０は、図３（ｂ）に示す電流通
路３２と比べて乾燥領域は小さいが、総合的な効果は両
経路を通る電流の和による。両電流通路３０・３２は複
合刃体１２と単純刃体１４との方向に伸びている。複合
刃体１２と単純刃体１４とが閉じるに従い、組織２８は
圧縮され、組織の乾燥した量が増加する。
【００２６】図３（ａ）および（ｂ）から分かるよう
に、図示するように時計方向に器具を回転させると、組
織２８と両刃体１２・１４との接触が増し、それによっ
て組織の接触インピーダンスが低下する。これは、外側
電極層１２Ａおよび単純刃体１４のいずれもが、組織と
の接触部分においては導電性の外側表面を有しているか
らである。
【００２７】また、単純刃体１４の剪断表面上には絶縁
層がないので、鋏が開放状態にあるときには、単純刃体
１４は組織２８と接触する。このため、複合刃体１２の
外側表面１２Ｅと切開面１２Ｆとともに、二極電子外科
回路が完結される。したがって、電流通路内には比較的
大容量の組織２８が含まれるので、機械的分離に先立っ
て広い乾燥範囲を得ることができる。
【００２８】再び図２を参照して、外側電極層１２Ａ、
絶縁層１２Ｂおよび内側導電層１２Ｃはすべて、複合刃
体１２の外側表面１２Ｅの一部を形成する露出面１２
（電子外科切開部）Ｇに沿って露出されている。この露
出面Ｇは、切開面１２Ｆの反対側にあり、電子外科ナイ
フとして使用することができる。単純刃体１４は複合刃
体１２よりも狭い。また、刃体が完全に閉鎖したときに
は、単純刃体１４の切開面１４Ｆは複合刃体１２の剪断
表面に沿ってはいるが、切開部１４Ｄを清潔にするため
に、露出面１２Ｇからは離れた位置にある。
【００２９】電子外科切開部である露出面１２Ｇを用い
る電子外科切開の効果は、切開部１２Ｄに近い組織中で
の電流密度を増すことにより強められる。不平衡出力を
有する発電機２６の場合には、この効果は、発電機２６
の「充電」あるいは「給電」用の出力端子である充電端
子２６Ａを単純刃体１４（または直接複合刃体１２の内
側導電層１２Ｃ）に、「接地」あるいは「帰還」用の出
力端子である接地端子２６Ｂを複合刃体１２の外側電極
層１２Ａにそれぞれ接続することにより達成される。こ
のような接続の効果を次に述べる。図３（ｃ）に示すよ
うに、少なくとも交流においては、発電機２６の接地端
子２６Ｂは発電機２６の内部接地母線２６Ｃに接続さ
れ、充電端子２６Ａは発振器あるいは増幅器出力２６Ｄ
に接続されているので、患部を通して地面に流れる漏洩
電流は充電端子２６Ａからの方が接地端子２６Ｂからよ
りも大きい。したがって、接地端子２６Ｂから地面に対
する静電容量が大きくなる。この結果、充電端子２６Ａ
から患部組織に流れる電流のうちのすべてが接地端子２
６Ｂを経由して帰るわけではなく、それらの電流のうち
のある部分は地面との間に静電容量を有する形で結合し
ていることになる。充電端子２６Ａを内側導電層１２Ｃ
に効果的に接続することにより、組織２８と電子外科切
開部である露出面１２Ｇとの間の接続部でのピーク電流
密度が最大となる。これは、電子外科切開部である露出
面１２Ｇでの内側導電層１２Ｃの表面積が外側電極層１
２Ａの表面積より小さいためである。
【００３０】乾燥のための好ましい電流分布は、電子外
科切開のための条件とは対照的に、組織２８と複合刃体
１２との間の接続部で出来るだけ均一に近いことが望ま
しい。したがって、図３（ａ）および（ｂ）に示すよう
に、乾燥と機械的切開とを統合したものとしては、充電
端子２６Ａは複合刃体１２の外側電極層１２Ａに接続
し、接地端子２６Ｂは単純刃体１４に（そして、内側導
電層１２Ｃに効果的に）接続するのが好ましい。そのた
めに、配線導体２４・２４から充電端子２６Ａや接地端
子２６Ｂへの各接続を、乾燥または電子外科切開の要求
に従って逆転させる切替スイッチ３４を備えるのが有利
である。図３（ｃ）に、この切替スイッチ３４をより詳
細に示す。切替スイッチ３４は、二対の接触子３４Ａと
接触子３４Ｂ、および双腕接触子３４Ｃを有する。双腕
接触子３４Ｃは、図３（ｃ）に示す第一動作位置から、
第二動作位置へ移動することができる。第一動作位置と
は、充電端子２６Ａが外側電極層１２Ａに接続され、接
地端子２６Ｂが単純刃体１４に接続され、器具が乾燥に
用いられる位置である。また、第二動作位置とは、充電
端子２６Ａが単純刃体１４に接続され、接地端子２６Ｂ
が外側電極層１２Ａに接続され、器具が電子外科切開に
用いられる位置である。
【００３１】切替スイッチ３４は、図１に示すように、
操作部１１に取り付けることができる。また、実際に切
り替え動作を行う接触子３４Ａ・３４Ｂおよび双腕接触
子３４Ｃは、発電機２６の中に配置し、接触子３４Ａ・
３４Ｂの動作は、切替スイッチ３４から制御配線３６を
通じて制御されるリレーによって動作されるようにする
のが好ましい。操作部１１はまた、電子外科電力の配線
導体２４・２４への印加を制御する開閉スイッチ４０を
有する。この機能に対する実際の開閉動作も同様に、開
閉スイッチ４０と発電機２６との間の制御配線４２を経
由して制御されるリレーによって行うようにすることが
できる。
【００３２】〔実施の形態２〕本発明の他の実施の形態
について図４ないし図６に基づいて説明すれば、以下の
通りである。図４ないし図６に示すように、本発明に係
る第二の電子外科切開器具は、湾曲した切開刃体であ
る、複合刃体（第一刃体）１２と単純刃体（第二刃体）
１４とを有している。その両刃体は、器具の長手方向の
軸から離れ、かつそれを横切る曲線の軸に沿って湾曲し
ている。複合刃体１２は、実施の形態１同様、外側電極
層１２Ａ、エポキシ樹脂接着剤で作られた絶縁層１２
Ｂ、および耐磨耗金属で作られた内側導電層１２Ｃを有
する。単純刃体１４は、図４に示すように、複合刃体１
２の曲率に合致するように湾曲している。前記実施の形
態同様、この単純刃体１４は単純な金属からなる部分で
ある。両刃体１２、１４は、横断旋回用の軸（旋回軸）
１６を中心に回転自在である。また、両刃体１２、１４
は、駆動部を機能させる軸１６から中央部に向かって伸
びる操作棒１８を有している。なお、上記駆動部は図示
しないが、図１の駆動部２２に類似する。図４は、配線
導体２４・２４を複合刃体１２と単純刃体１４との操作
棒１８・１８に取り付ける様子を示す。特に、図５・図
６に示すように、複合刃体１２には、強度を増強するた
めに、外側のリブ１２Ｈが形成されている。
【００３３】
【発明の効果】本発明の請求項１記載の電子外科切開器
具は、第一刃体および第二刃体のうちの少なくとも一方
が他方とともに鋏動作を行うために本体に旋回軸を介し
て取り付けられており、第一および第二刃体に電子外科
電圧を印加するための一対の配線導体が本体に設けられ
ている電子外科切開器具において、上記第一刃体は、外
側電極層、内側導電層、および外側電極層と内側導電層
との間に挟持された絶縁層を含む複合刃体であり、上記
配線導体は、外側電極層および内側導電層にそれぞれ接
続されている構成である。
【００３４】それゆえ、組織の接触インピーダンスを低
下させて、分離前に組織を効率よく乾燥することができ
るという効果を奏する。
【００３５】また、機械的分離に先立って、広範囲の組
織を乾燥することができるという効果を奏する。
【００３６】請求項２記載の電子外科切開器具は、請求
項１記載の電子外科切開器具であって、配線導体の一本
は内側導電層に直接接続されている構成である。
【００３７】請求項３記載の電子外科切開器具は、請求
項１記載の電子外科切開器具であって、配線導体の一本
は、第二刃体に結合されるとともに、第二刃体と上記内
側導電層との間の電気的接触によって上記内側導電層に
電気的に接続されている構成である。
【００３８】請求項４記載の電子外科切開器具は、請求
項３記載の電子外科切開器具であって、第二刃体は上記
内側導電層と電気的に接触した導電部を有し、上記配線
導体と上記導電部とは、配線導体と内側導電層との間に
上記導電部が電気的に直列に位置するように接続されて
いる構成である。
【００３９】請求項５記載の電子外科切開器具は、請求
項１ないし４のいずれかに記載の電子外科切開器具であ
って、上記各刃体は漸進して剪断するように方向付けら
れた切開部を有し、上記各切開部は金属材料で構成され
ている。
【００４０】請求項６記載の電子外科切開器具は、請求
項５記載の電子外科切開器具であって、上記第二刃体は
全体が金属体であり、この金属体に上記切開部を設けた
構成である。
【００４１】請求項７記載の電子外科切開器具は、請求
項１ないし６のいずれかに記載の電子外科切開器具であ
って、上記刃体の両方が上記本体に上記旋回軸を介して
取り付けられた構成である。
【００４２】請求項８記載の電子外科切開器具は、請求
項１ないし７のいずれかに記載の電子外科切開器具であ
って、上記各刃体は長手部材を備え、上記長手部材は、
外側表面、剪断表面、および切開部を有し、上記切開部
は上記刃体に沿って形成されており、上記剪断表面の一
方の側に沿って上記剪断表面と外側表面との間の境界を
定めており、上記両刃体は、上記剪断表面が互いに向か
い合った関係を保ちつつ閉鎖状態へ移行する際に、上記
各切開部が剪断動作を進めていくように本体に取り付け
られており、上記第一刃体について、上記外側表面は、
その切開部に隣接した、刃体に沿う切開面を定めてお
り、上記内側導電層、絶縁層、および外側電極層のそれ
ぞれは、上記切開面に沿って露出されており、上記剪断
表面は、上記内側導電層上の、少なくとも、上記切開部
に隣接した部分に形成されている構成である。
【００４３】請求項９記載の電子外科切開器具は、請求
項８記載の電子外科切開器具であって、上記第二刃体
は、導電部と、切開部に隣接して刃体に沿った切開面を
有し、上記導電部は、少なくとも切開部において、切開
面に沿って露出されている構成である。
【００４４】請求項１０記載の電子外科切開器具は、請
求項９記載の電子外科切開器具であって、上記第二刃体
の導電部は、少なくとも第二刃体の剪断表面の大部分に
おいて露出されている構成である。
【００４５】請求項１１記載の電子外科切開器具は、請
求項８ないし１０のいずれかに記載の電子外科切開器具
であって、上記第一刃体の外側電極層、絶縁層および内
側電導層はそれぞれ、第一刃体の剪断表面に隣接して第
一刃体に沿った、第一刃体の上記外側表面の一部をなす
電子外科切開部に沿って露出されている構成である。
【００４６】請求項１２記載の電子外科切開器具は、請
求項１１に記載の電子外科切開器具であって、上記電子
外科切開部は、第一刃体の剪断表面について、上記切開
部とは反対の側に隣接して、第一刃体に沿って伸延して
おり、上記両刃体の閉鎖状態にあっては、第二刃体の切
開部が第一刃体の剪断面に沿い、かつ、第一刃体の電子
外科切開部からは離れているように、上記両刃体が配置
されている構成である。
【００４７】請求項１３記載の電子外科切開器具は、請
求項１ないし１２のいずれかに記載の電子外科切開器具
であって、配線の接続を逆転させるスイッチを備えた構
成である。
【００４８】請求項１４記載の電子外科切開装置は、電
子外科用発電機および請求項１ないし１３のいずれかに
記載の単相電子外科切開器具を備え、上記電子外科用発
電機は、充電端子と接地端子とを有する不平衡出力を有
し、組織の乾燥と機械的切開に対しては、上記充電端子
が第一刃体の外側電極層に接続されるように、上記配線
導体が配設されている構成である。
【００４９】請求項１５記載の電子外科切開装置は、電
子外科用発電機および請求項１ないし１３のいずれかに
記載の単相電子外科切開器具を備え、上記電子外科用発
電機は、充電端子と接地端子とを有する不平衡出力を有
し、電子外科切開に対しては、上記接地端子が第一刃体
の外側電極層に接続されるように、上記配線導体が配設
されている構成である。
【００５０】請求項１６記載の電子外科切開装置は、請
求項１５記載の電子外科切開装置であって、上記電子外
科切開器具は、上記電子外科用発電機から刃体に出力す
る端子の接続を逆転するスイッチを有する構成である。
【図面の簡単な説明】
【図１】本発明の電子外科切開器具の一構成例の概略の
構成を示す平面図である。
【図２】図１のＡ−Ａ断面での刃体の構成を示す断面図
である。
【図３】刃体の構成を示す断面図である。
【図４】本発明の電子外科切開器具の他の構成例におけ
る刃体の構成を示す平面図である。
【図５】図４の刃体の端部の構成を示す斜視図である。
【図６】図４のＸ−Ｘ断面での刃体の構成を示す断面図
である。
【符号の説明】
１０ 本体 １１ 操作部 １２ 複合刃体（第一刃体） １２Ａ 外側電極層 １２Ｂ 絶縁層 １２Ｃ 内側導電層 １２Ｄ 切開部（機械切開部） １２Ｅ 外側表面 １２Ｆ 切開面 １２Ｇ 露出面（電子外科切開部） １２Ｈ リブ １４ 単純刃体（第二刃体） １４Ｄ 切開部（機械切開部） １４Ｆ 切開面 １６ 軸（旋回軸） １８ 操作棒 １８Ａ ピン ２０ 溝 ２２ 駆動部 ２２Ａ 制御棒 ２４ 配線導体 ２６ 発電機（電子外科電源） ２６Ａ 充電端子 ２６Ｂ 接地端子 ２６Ｃ 内部接地母線 ２６Ｄ 増幅器出力 ２８ 組織 ３０ 電流通路 ３２ 電流通路 ３４ 切替スイッチ ３４Ａ 接触子 ３４Ｂ 接触子 ３４Ｃ 双腕接触子 ３６ 制御配線 ４０ 開閉スイッチ ４２ 制御配線
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Claims (16)

    【特許請求の範囲】
  1. 【請求項１】第一刃体および第二刃体のうちの少なくと
    も一方が他方とともに鋏動作を行うために本体に旋回軸
    を介して取り付けられており、第一および第二刃体に電
    子外科電圧を印加するための一対の配線導体が本体に設
    けられている電子外科切開器具において、 上記第一刃体は、外側電極層、内側導電層、および外側
    電極層と内側導電層との間に挟持された絶縁層を含む複
    合刃体であり、 上記配線導体は、外側電極層および内側導電層にそれぞ
    れ接続されていることを特徴とする電子外科切開器具。
  2. 【請求項２】配線導体の一本は内側導電層に直接接続さ
    れていることを特徴とする請求項１記載の電子外科切開
    器具。
  3. 【請求項３】配線導体の一本は、第二刃体に結合される
    とともに、第二刃体と上記内側導電層との間の電気的接
    触によって上記内側導電層に電気的に接続されているこ
    とを特徴とする請求項１記載の電子外科切開器具。
  4. 【請求項４】第二刃体は上記内側導電層と電気的に接触
    した導電部を有し、 上記配線導体と上記導電部とは、配線導体と内側導電層
    との間に上記導電部が電気的に直列に位置するように接
    続されていることを特徴とする請求項３記載の電子外科
    切開器具。
  5. 【請求項５】上記各刃体は漸進して剪断するように方向
    付けられた切開部を有し、上記各切開部は金属材料で構
    成されていることを特徴とする請求項１ないし４のいず
    れかに記載の電子外科切開器具。
  6. 【請求項６】上記第二刃体は全体が金属体であり、この
    金属体に上記切開部を設けたことを特徴とする請求項５
    記載の電子外科切開器具。
  7. 【請求項７】上記刃体の両方が上記本体に上記旋回軸を
    介して取り付けられたことを特徴とする請求項１ないし
    ６のいずれかに記載の電子外科切開器具。
  8. 【請求項８】上記各刃体は長手部材を備え、 上記長手部材は、外側表面、剪断表面、および切開部を
    有し、 上記切開部は上記刃体に沿って形成されており、上記剪
    断表面の一方の側に沿って上記剪断表面と外側表面との
    間の境界を定めており、 上記両刃体は、上記剪断表面が互いに向かい合った関係
    を保ちつつ閉鎖状態へ移行する際に、上記各切開部が剪
    断動作を進めていくように本体に取り付けられており、 上記第一刃体について、 上記外側表面は、その切開部に隣接した、刃体に沿う切
    開面を定めており、 上記内側導電層、絶縁層、および外側電極層のそれぞれ
    は、上記切開面に沿って露出されており、 上記剪断表面は、上記内側導電層上の、少なくとも、上
    記切開部に隣接した部分に形成されていることを特徴と
    する請求項１ないし７のいずれかに記載の電子外科切開
    器具。
  9. 【請求項９】上記第二刃体は、導電部と、切開部に隣接
    して刃体に沿った切開面を有し、 上記導電部は、少なくとも切開部において、切開面に沿
    って露出されていることを特徴とする請求項８記載の電
    子外科切開器具。
  10. 【請求項１０】上記第二刃体の導電部は、少なくとも第
    二刃体の剪断表面の大部分において露出されていること
    を特徴とする請求項９記載の電子外科切開器具。
  11. 【請求項１１】上記第一刃体の外側電極層、絶縁層およ
    び内側電導層はそれぞれ、第一刃体の剪断表面に隣接し
    て第一刃体に沿った、第一刃体の上記外側表面の一部を
    なす電子外科切開部に沿って露出されていることを特徴
    とする請求項８ないし１０のいずれかに記載の電子外科
    切開器具。
  12. 【請求項１２】上記電子外科切開部は、第一刃体の剪断
    表面について、上記切開部とは反対の側に隣接して、第
    一刃体に沿って伸延しており、 上記両刃体の閉鎖状態にあっては、第二刃体の切開部が
    第一刃体の剪断面に沿い、かつ、第一刃体の電子外科切
    開部からは離れているように、上記両刃体が配置されて
    いることを特徴とする請求項１１記載の電子外科切開器
    具。
  13. 【請求項１３】配線の接続を逆転させるスイッチを備え
    たことを特徴とする請求項１ないし１２のいずれかに記
    載の電子外科切開器具。
  14. 【請求項１４】電子外科用発電機および請求項１ないし
    １３のいずれかに記載の電子外科切開器具を備え、 上記電子外科用発電機は、 充電端子と接地端子とを有する不平衡出力を有し、 組織の乾燥と機械的切開に対しては、上記充電端子が第
    一刃体の外側電極層に接続されるように、上記配線導体
    が配設されていることを特徴とする電子外科切開装置。
  15. 【請求項１５】電子外科用発電機および請求項１ないし
    １３のいずれかに記載の電子外科切開器具を備え、 上記電子外科用発電機は、 充電端子と接地端子とを有する不平衡出力を有し、 電子外科切開に対しては、上記接地端子が第一刃体の外
    側電極層に接続されるように、上記配線導体が配設され
    ていることを特徴とする電子外科切開装置。
  16. 【請求項１６】上記電子外科切開器具は、上記電子外科
    用発電機から刃体に出力する端子の接続を逆転するスイ
    ッチを有することを特徴とする請求項１５記載の電子外
    科切開装置。
JP33369595A 1994-12-21 1995-12-21 電子外科切開器具とそれを用いた電子外科切開装置 Expired - Lifetime JP3842320B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9425781.3 1994-12-21
GBGB9425781.3A GB9425781D0 (en) 1994-12-21 1994-12-21 Electrosurgical instrument

Publications (2)

Publication Number Publication Date
JPH08252263A true JPH08252263A (ja) 1996-10-01
JP3842320B2 JP3842320B2 (ja) 2006-11-08

Family

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Country Link
US (1) US5860975A (ja)
EP (1) EP0717966B1 (ja)
JP (1) JP3842320B2 (ja)
KR (1) KR100439328B1 (ja)
CN (1) CN1102845C (ja)
AT (1) ATE236584T1 (ja)
AU (1) AU713677B2 (ja)
CA (1) CA2165738C (ja)
DE (1) DE69530270T2 (ja)
ES (1) ES2196043T3 (ja)
FI (1) FI114609B (ja)
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AU4052095A (en) 1996-06-27
CA2165738A1 (en) 1996-06-22
CN1130052A (zh) 1996-09-04
KR960020947A (ko) 1996-07-18
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KR100439328B1 (ko) 2004-10-06
CN1102845C (zh) 2003-03-12
JP3842320B2 (ja) 2006-11-08
GB9425781D0 (en) 1995-02-22
NO955139L (no) 1996-06-24
US5860975A (en) 1999-01-19
NO320071B1 (no) 2005-10-17
FI956124A (fi) 1996-06-22
FI956124A0 (fi) 1995-12-19
AU713677B2 (en) 1999-12-09
DE69530270D1 (de) 2003-05-15
EP0717966B1 (en) 2003-04-09
EP0717966A1 (en) 1996-06-26
ATE236584T1 (de) 2003-04-15
TW286272B (ja) 1996-09-21
ES2196043T3 (es) 2003-12-16
NO955139D0 (no) 1995-12-18
DE69530270T2 (de) 2004-03-04
FI114609B (fi) 2004-11-30

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